This week we will be doing some short cases based around some pictures. Each case will last around 24-36 hours, so get in quick! As always – the information is posted here and the discussion will be on Twitter. Follow @teamhaem and when you want to make a comment reply to us and also use #teamhaem so everyone else can follow the proceedings. We’re really keen to get a mix of people contributing.

The following pictures are taken from a bone marrow aspirate of a 75 year old gentleman.

His blood count is

Hb 67g/L (135-180)

MCV 110fL (79-98)

WCC 9.6×10*9/L (4-11)

PLT 233×10*9/L (150-400)

Questions:

Can you describe what’s going on here?

What can cause this?

What tests would you do?

Please reply to us (@TeamHaem) on Twitter and always include #TeamHaem to allow others to follow your comments. Please join in the debate and learn about haematological problems along the way. The case will continue to evolve over the coming days so keep checking #TeamHaem on Twitter for more information.